医学
微透析
外科
乳房再造术
回顾性队列研究
队列
乳腺癌
内科学
癌症
中枢神经系统
作者
Iain S. Whitaker,Warren M. Rozen,Daniel Chubb,Rafael Acosta,Birgitte Jul Kiil,Hanne Birke-Sørensen,Damien Grinsell,Mark W. Ashton
出处
期刊:Journal of Reconstructive Microsurgery
[Georg Thieme Verlag KG]
日期:2010-03-10
卷期号:26 (06): 409-416
被引量:54
标识
DOI:10.1055/s-0030-1249607
摘要
Many techniques for flap monitoring following free tissue transfer have been described; however, there is little evidence that any of these techniques allow for greater rates of flap salvage over clinical monitoring alone. We sought to compare three established monitoring techniques across three experienced microsurgical centers in a comparable cohort of patients. A retrospective, matched cohort study of 398 consecutive free flaps in 347 patients undergoing autologous breast reconstruction was undertaken across three institutions during the same 3-year period, with a single form of postoperative monitoring used at each institution: clinical monitoring alone, the Cook-Swartz implantable Doppler probe, or microdialysis. Both objective and subjective measures of efficacy were assessed. Clinical monitoring alone, the implantable Doppler probe, and microdialysis showed statistically similar rates of flap salvage. False-negative rates were also statistically similar (only seen in the clinically monitored group). However, there was a statistically significant increase in false-positive alarms causing needless take-backs to theater in the microdialysis and implantable Doppler arms, P < 0.001. This study did not find any technique superior to clinical monitoring alone. New monitoring technologies should be compared objectively with clinical monitoring as the current standard in postoperative flap monitoring.
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